Basic Information
| Provider Information | |||||||||
| NPI: | 1740742147 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STRICKLAND | ||||||||
| FirstName: | RANDY | ||||||||
| MiddleName: | LORENZO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1055 E COLORADO BLVD STE 5125 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911062327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6614021545 | ||||||||
| FaxNumber: | 6617270006 | ||||||||
| Practice Location | |||||||||
| Address1: | 43845 10TH ST W STE 2A | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935344800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6614021545 | ||||||||
| FaxNumber: | 6617270006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2019 | ||||||||
| LastUpdateDate: | 06/11/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | ASW3411179 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.